The WelbeHealth PACE helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. We serve our most vulnerable seniors with better quality and compassion in a value-based model.
The Director, Central ERD plays a critical role in bringing PACE services to vulnerable seniors across the country. This role is accountable for reviewing Levels of Care (LOC) and overseeing WelbeHealth’s central eligibility requirement determination (ERD) process.
Essential Job Duties:
- Review LOC assessments completed by Enrollment RNs against standardized criteria for PACE to ensure eligibility decisions are made consistently, accurately, and in compliance with state and federal regulations
- Assess whether additional assessments by members of the WelbeHealth care teams (social work, behavioral health, home, medical practice) are needed to further assess eligibility
- Oversee direct reports including hiring, training, supervising, and mentoring
- Partner closely with program, enrollment, and medial leadership in decision-making for complex cases
- Serve as the key person in the review process, including proactively working to reduce bottlenecks and pulling in additional reviewers as needed to enable timely enrollment
- Continuously assess existing central ERD processes to identify improvement opportunities, escalate concerns as needed, and collaborate with key stakeholders to drive enhancements
- Document and monitor enrollment outcome data, including denial and deferral rates
Job Requirements:
- Bachelor’s degree required; RN or MSW degree preferred
- Minimum of five (5) years of experience with a frail or elderly population, ideally in PACE with a strong understanding of the PACE care model
- Minimum of two (2) years of supervisory experience with demonstrated ability to mentor and develop team members
- Excellent leadership, organizational, and communication skills in settings with seniors, their families and interdisciplinary team members
- Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects
Benefits of working at WelbeHealth: Apply your expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.
- 401k + employer match
- Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
- 17 days of personal time off (PTO), 12 holidays observed annually, 6 sick days
- And additional benefits
Salary/Wage base range for this role is $145,399 - $191,926 / year + Bonus + Equity. WelbeHealth offers competitive total rewards package that includes, 401k match, healthcare coverage and a broad range of other benefits. Actual pay will be adjusted based on experience and other qualifications.
COVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
Beware of Scams
Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to [email protected]
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What We Do
WelbeHealth provides full-service care to help seniors age well at home and in their community, often at no cost. Services include medical, coordination, home care, dental, transport, physical therapy, prescriptions, social activities and meals.
Founded by a seasoned group of physician entrepreneurs, our leadership team hails from leading payer and provider organizations such as GoHealth Urgent Care, BAYADA Home Health, AirStrip Technologies, Evolent Health, and On Lok.
With funding from leading venture investors, we're looking for team members who are inspired to help us deliver on our mission of unlocking the full potential of the most vulnerable seniors. Our colleagues are energized by working in diverse groups toward our shared purpose, are eager to drive groundbreaking innovations, and have the courage to care for our participants with empathy and love.
